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Physician created priority access health plan benefits Mid-Missouri patients, employers, providers

Posted on Tuesday, October 9, 2018 at 4:02 pm

The NueHealth Provider Network Priority Access Health Plan, available now to businesses with 10 or more employees, benefits patients, employers, and physicians. The Priority Access Health Plan, or PAHP, allows businesses to provide their employees the health care coverage they need and brings additional value with technology-enhanced features that make it easier to get direct care from their primary care physicians.

The network includes most local private practice physician offices, with primary care providers and

Boone Hospital Center is introducing a new health insurance model.

Boone Hospital Center is introducing a new health insurance model.

specialists from Boone Hospital Center’s medical staff, including Tiger Pediatrics, Columbia Orthopaedic Group and Missouri Heart Center, but doesn’t restrict from seeing preferred physicians.

The PAHP offers different plan levels of priority access to the primary care provider, or PCP, similar to a concierge medicine plan, but without the high cost.

All the plans include technology-enhanced features that make it easy to get care from participating PCP without an office visit. Using a HIPAA-compliant, secure app on a smartphone phone, a patient can send their PCP a text message or request a video or voice chat. Unlike telemedicine, where a contracted physician in another city consults with patients, patients will be able to communicate directly with their doctor or a professional in their office. If their medical need requires an in-office visit, the PAHP ensures they’ll be seen by their PCP within 24 hours. If they require a referral to a specialist, they won’t wait longer than a week to be seen.

John D. Miles, MD, a surgeon with Columbia Orthopaedic Group and other physicians from Boone Hospital Center’s medical staff joined forces to offer mid-Missouri employers this new option.

“We have most private practitioners in Columbia already signed up, but ours is not a narrow network,” Dr. Miles explains. “It doesn’t exclude physicians. We have a wrap network to provide coverage outside of our area, and for services not provided at Boone Hospital.”

The plan also offers health screenings and health risk assessments, and coverage for prescriptions, vaccinations, screenings and various treatments.

In traditional insurance plans, primary care physicians are only compensated for patient office visits and often provide hours of uncompensated care. The PAHP compensates PCPs in the network for all patient care, whether or not they need an in-person appointment.

“With this model, physicians get to do what they actually like to do in terms of caring for people. Their patient load will be less hectic, and their satisfaction of caring for people will be much higher,” Dr. Miles says.

The PAHP is also more accessible and affordable for local employers. Businesses with as few as 10 employees – or as many as thousands – can participate. For small businesses especially, the PAHP can cost less than traditional insurance options.

Employers interested in offering the PAHP to their employees are encouraged to  consult with their insurance brokers for a quote, or contact the webpage PriorityAccessHealth.com for more information about the plan.

While NueHealth Priority Access Health Plan partners with national third-party administrators, stop loss carriers, managing general underwriters and pharmacy benefits managers, mid-Missouri physicians have led the way on building the plan.

“Boone Hospital Center medical staff doctors have personally funded and developed this program, and we’ve done it on a shoestring,” Dr. Miles says. “Your doctors have made a hometown solution for hometown people.”